A Pipe Dream?

01 အောက်တိုဘာလ 2005

Online version with photos

It is one of the most baffling ironies in this age of globalization that while developing countries like Burma are being urged to destroy their opium stocks and poppy fields, others in the developed world are being encouraged to produce the drug for use in pharmaceuticals.

Australia is the largest producer of legally permitted opium, doubling production in the past five years. Opium production in Spain tripled in that time, while legally-sanctioned poppy fields prosper in France, India, Turkey and Hungary. Even Britain is now growing opium poppies legally. The state monopoly in India, meanwhile, produces about the same amount of legal opium - 821 tons in 2002 - as Burma does illegally (828 tons). Worldwide, more opium is produced legally than illegally.

Yet, doctors in one of the major producing countries - Burma - complain of a critical shortage of drugs for pain relief. In hospitals across the country, terminal cancer and AIDS patients, and also people recovering from surgery, are suffering unnecessary pain. There are even doctors who advise the relatives of AIDS patients who can no longer bear to see family members or friends suffer in their final weeks to buy illegal heroin to alleviate their pain.

Every year, the Rangoon government burns large quantities of seized narcotics to celebrate the International Day Against Drug Abuse and Illicit Trafficking on June 26. This year, 635 kg of opium was burned, along with many other confiscated drugs. Since 1990, according to official figures, some 34 tons of opium have been destroyed at 19 national and 34 local destruction ceremonies, although there have been suggestions that some was diverted by corrupt officials.

Burning opium is a waste of valuable raw material that can be converted relatively easily into morphine for medical purposes. In the past, some of the seized opium was in fact used for processing in the pharmaceutical industry. The Burmese Ministry of Industry stopped that several years ago, though last year a small amount was used again for medicines, but not enough to address the chronic shortage.

The situation is not limited to Burma. Repeatedly, the World Health Organization and the International Narcotics Control Board draw attention to the shortage of essential narcotic drugs needed for medical purposes. Opiates like morphine and codeine, derived from the opium poppy, are highly effective medicines for pain relief, but also for cough treatment and the treatment of chronic diarrhoea, as many traditional opium users well know.

Developing countries, which represent about 80 percent of the world’s population, account for only about 6 percent of the global consumption of morphine, the World Health Assembly was told recently. This imbalance has resulted in many governments not being able to provide adequate care for the thousands of patients suffering from cancer or AIDS.

"Making narcotic drugs and psychotropic substances available to the large number of people suffering from cancer and AIDS pain are not only important objectives of public health but they will also bring peace to the suffering and their families", the INCB representative told the assembly.

The INCB was established after enforcement of the 1961 UN Single Convention on Narcotic Drugs 21, which included an international control system for opium production. The INCB’s mandate is to ensure that adequate supplies of drugs are available for medical and scientific uses, and that leakages from legally-sanctioned sources to illicit traffic do not occur. In its report for 2002, the INCB appealed to the authorities of countries - particularly those in Africa and Asia - "where the consumption of analgesics for the treatment of moderate to severe pain continues to be extremely low, to consider low-cost initiatives to improve the availability of opioid analgesics" (morphine-like pain-killers). In 2004 the Board encouraged countries "to take steps to increase the medical use of opiates in their countries in order to meet their real needs for the treatment of pain".

When global prohibition was established back in 1961, the understanding was that traditional opium-cultivating countries should be permitted to licitly cultivate opium, and that importing countries should obtain 80 percent of their opiate requirements from those countries, the so-called 80:20 rule. The US - the largest importer of licit opiates - has been following this rule, but the agreement ends in January 2006. India has expressed concern over "rumors in the USA that 80:20 rules may be relaxed to accommodate Afghanistan to reconstruct and help the war-torn economy".

At the UN Commission on Narcotic Drugs in March 2004, Afghanistan did indeed raise the question of obtaining permission to turn part of its illicit opium production into a licit one, but the proposal met with strong opposition from India and Australia. Only India and Turkey have so far successfully applied for the status of traditional opium cultivating country, though at the time of the negotiations of the 1961 Convention, it was clear that the right to continue to produce and export opium for medicinal purposes applied not only to India and Turkey but to a broader group of countries, mentioning Afghanistan and Burma by name.

In its latest report the INCB also addressed the issue of the release of confiscated opium for the manufacture of narcotic drugs for medical purposes and made clear that it "is not prohibited under the 1961 Convention". However, "to avoid unforeseen imbalances between the licit supply of and demand for opiates caused by the exportation of products manufactured from seized and confiscated drugs", the Board requests countries "to restrict the use of such products to domestic use only".

Iran, the country with the highest record of opium seizures, converts everything in its pharmaceutical industry into morphine and codeine. Iran even exports licit opiates produced on the basis of seized illicit opiates coming from Afghanistan. There are no international legal restrictions to prevent Burma from at least producing enough to satisfy the country’s growing domestic needs for pain treatment.